According to the National Child Measuring Programme around one in four 10-11 year olds in England is obese, and at risk of developing obesity-related disease in adulthood. Now, researchers from Kings College London havefor the first time revealed the impact of obesity on the hearts anatomyforyoung children, specifically, how the heart adapts to obesity and the extra demandit generates independently from other factors such as natural growth and development.

The study, published inEuropean Heart Journal Cardiovascular Imaging, is the first study to characterise the paediatric heart in 3D, and lookedattheleft ventricle.

Using a comprehensive set of cardiovascular magnetic resonance (CMR) scans of 2631 children aged 10, 51.3% of whom were girls, the researchers reconstructed the left ventricular 3D anatomy of each subject. Data used came from the Generation R study - a population-based prospective cohort study from foetal life onwards in the Netherlands, with extensive data collection used to examine the development of the cardiovascular system and early cardiovascular risk factors.

The researchers found that the left ventricle acquires a circular cross-section. It also becomes tilted away from the normal vertical symmetry, something that has also been shown to be present in patients with aortic stenosis.

A notable finding, the researchers said, was that the cardiac remodelling became significant at a BMI of roughly 19 in children aged 10, which corresponds to the overweight threshold BMI of 25 in adults.

Heart Researcher Professor Pablo Lamata said: "In the future, this pattern of remodelling could inform risk prediction models and raise an earlier awareness of the importance of adopting a healthier lifestyle from childhood."

The researchers emphasised that obesity-related conditions are the leading causes of preventable death, pointing out that the "increased cardiovascular disease (CVD) risk associated with obesity is not only driven by hypertension, diabetes, obstructive sleep apnoea, and coronary artery disease but also by structural and functional cardiac changes".

They explained how part of the adult CVD risk associated with obesity may already develop in childhood, commenting that the "Bogalusa Heart Study demonstrated that childhood obesity is associated with adult left ventricular dilatation (LV) and hypertrophy", and concluded that childhood BMI was the only independent predictor of LV hypertrophy in adulthood.

They also pointed out that epidemiological studies in children indicate that "LV hypertrophy develops in response to obesity in childhood".

The authors explained how they have identified unique anatomical features related to childhood obesity that could aid in risk stratification, adding that their findings demonstrate how the heart adapts in response to increasing BMI by "increasing both roundness of the shape and septal wall thickness to cope with higher work demand".

Lead researcher Maciej Marciniak said: "Obesity in children is of course a major concern, as it may impact the healthy development. With more clinical information on this impact, clinicians will be able to better advise patients to follow healthier lifestyles at an earlier age."

With their findings, the researchers say understanding and quantifying the impact of obesity on development is becoming much clearer. They hope that the results of their research will provide the potential to aid the detection of individual future risks during adulthood.

Lead researcher Maciej Marciniak said: "Looking further down the line, such analyses may help to inform about other remodelling patterns, connected with lifestyle choices, environmental factors and other parameters."

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Impact of Obesity on Children's Heart Anatomy Revealed for First Time - Medscape